Scrotal Lesions of Metastatic Rectal Adenocarcinoma: Case Report and Literature Review
Abstract
Secondary scrotal tumors originating from viscera are rare and indicate a poor prognosis. We report a patient who underwent abdominoperineal resection due to his rectal cancer. Tumor recurrence at the surgical site led to prostate involvement. About 1 month after the prostatectomy, scrotal skin metastasis presented as bilateral papulonodular lesions. Finally, brain metastasis occurred and caused his death. Also, several ways by which malignancies can metastasize to scrotum have been discussed.
1. Habr-Gama A. Assessment and management of the complete clinical response of rectal cancer to chemoradiotherapy. Colorectal Dis 2006;8:21-4.
2. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. Cancer J Clin 2013;63:11-30.
3. August DA, Ottow RT, Sugarbaker PH. Clinical perspective of human colorectal cancer metastasis. Cancer Metastasis Rev1984;3:303-24.
4. Tonyali O, Sumbul AT, Ozturk MA, Koyuncuer A, Ekiz F. A case of rectal adenocarcinoma presented with palatine tonsil metastasis. J Oncol Pharmacy Pract 2014;22:341-3.
5. Van Cutsem E, Nordlinger B, Adam R, Kohne CH, Pozzo C, Poston G, et al. Towards a pan-European consensus on the treatment of patients with colorectal liver metastases. Eur J Cancer 2006;42:2212-21.
6. Hess KR, Varadhachary GR, Taylor SH, Wei W, Raber MN, Lenzi R, et al. Metastatic patterns in adenocarcinoma. Cancer 2006;106:1624-33.
7. Iiyama T, Watanabe H. Scrotal metastasis from ureteral cancer. J Urol 2001;165:1637.
8. Aydin GB, Ciftci AO, Yalcin B, Akcoren Z, Caglar M, Senocak ME, et al. Paratesticular metastasis from Wilms tumor associated with a hydrocele. Pediatr Blood Cancer 2006;47:97-9.
9. Nouhaud FX, Di Fiore F, Noel N, Gobet F, Pfister C. Scrotal metastasis from a nonmuscle-infiltrative bladder cancer: a surprising clinical evolution. Urology 2012;80:e37-8.
10. Norberg SM, Oros M, Manucha V, Eun D, Bilusic M. Loss of e-cadherin and retinoblastoma genes in a case of urothelial carcinoma with scrotal metastasis. Can J Urol 2015;22:7755-7.
11. Pichler R, Tulchiner G, Aigner F, Horninger W, Heidegger I. Paratesticular Metastasis of a Clear-Cell Renal-Cell Carcinoma With Renal Vein Thrombus Mimicking Primary Testicular Cancer. Clin Genit Cancer 2017;15:e123-e6.
12. Leung ST, Chu CY, Lai BM, Cheung FM, Khoo JL. Scrotal wall metastasis as the first manifestation of primary gastric adenocarcinoma. Hong Kong Med J 2014;20:70-3.
13. Thomas R, Swamy S. Rare case of gastrointestinal stromal tumor presenting with scrotal metastasis. Ind J Surg 2015;77:188-9.
14. Coussa-Koniski ML, Maalouf PA, Raad NE, Bejjani NA. Scrotal wall metastasis from a primary lung adenocarcinoma. Respir Med Case Rep 2015;15:77-9.
15. Gates O. Cutaneous Metastases of Malignant Disease. Am J Cancer 1937;30:718-30.
16. Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol 1993;29:228-36.
17. Gmitter TL, Dhawan SS, Phillips MG, Wiszniak J. Cutaneous metastases of colonic adenocarcinoma. Cutis 1990;46:66-8.
18. Reingold IM. Cutaneous metastases from internal carcinoma. Cancer 1966;19:162-8.
19. Shetty MR, Khan F. Carcinoma of the Rectum with Scrotal Metastases. Br J Urol 1988;62:612.
20. Boucher KW, Heymann WR. Ulcerated papules of the scrotum. Arch Dermatol 2001;137:495-500.
21. Hayashi H, Shimizu T, Shimizu H. Scrotal metastases originating from colorectal carcinoma. Clin Exp Dermatol 2003;28:226-7.
22. Reuter J, Bruckner-Tuderman L, Braun-Falco M. Epidermotropic scrotal metastasis of colorectal cancer. Int J Color Dis 2007;22:1133-4.
23. McWeeney DM, Martin ST, Ryan RS, Tobbia IN, Donnellan PP, Barry KM. Scrotal metastases from colorectal carcinoma: a case report. Case J 2009;2:111.
24. Balta I, Vahaboglu G, Karabulut AA, Yetisir F, Astarci M, Gungor E, et al. Cutaneous metastases of rectal mucinous adenocarcinoma mimicking granuloma inguinale. Int Med 2012;51:2479-81.
25. Ozgen A, Karakaya E, Bozdogan N. Scrotal skin metastasis from rectum adenocarcinoma. Rare Tumors 2013;5:e60.
26. Udkoff J, Cohen PR. Adenocarcinoma of the colon presenting with scrotal metastasis: case report and review of the literature. Dermatol Online J 2016;22:13030.
27. Dehal A, Patel S, Kim S, Shapera E, Hussain F. Cutaneous Metastasis of Rectal Cancer: A Case Report and Literature Review. Perm J 2016;20:74-8.
28. Lookingbill DP, Spangler N, Sexton FM. Skin involvement as the presenting sign of internal carcinoma. A retrospective study of 7316 cancer patients. J Am Acad Dermatol 1990;22:19-26.
29. Swofford BP, Dragovich T. Sigmoid Adenocarcinoma with Regional Scrotal Metastasis. Case Rep Oncol 2017;10:416-9.
30. Hanash KA, Carney JA, Kelalis PP. Metastatic tumors to testicles: routes of metastasis. J Urol 1969;102:465-8.
31. Pienkos EJ, Jablokow VR. Secondary testicular tumors. Cancer 1972;30:481-5.
32. Fowler A, Cook R, Biggs M, Little N, Assaad N, McDonald K. Survival of patients following neurosurgical treatment of colorectal adenocarcinoma metastasis in the Northern Sydney-Central Coast area. J Clin Neurosci 2008;15:998-1004.
33. WroĊski M, Arbit E. Resection of brain metastases from colorectal carcinoma in 73 patients. Cancer 1999;85:1677-85.
34. Michail P, Amith I, George S, George MK. A case of calcified metastatic colorectal adenocarcinoma mimicking a benign lesion: pitfalls in diagnosis. Case Rep Oncol Med 2015;2015:936260.
35. Melis M, Scintu F, Marongiu L, Mascia R, Frau G, Casula G. Inflammatory cutaneous metastasis from rectal adenocarcinoma: report of a case. Dis Colon Rectum 2002;45:562-3.
36. Goris Gbenou MC, Wahidy T, Llinares K, Cracco D, Perrot A, Riquet D. Atypical Phimosis Secondary to a Preputial Metastasis from Rectal Carcinoma. Case Rep Oncol 2011;4:542-6.
37. Wu G, Gu BJ, Nastiuk KL, Gu J, Wu DL. Metastasis to scrotal skin as the initial manifestation in a patient with rectal adenocarcinoma: a rare case report and literature review. Asian J Androl 2016;18:492-3.
2. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. Cancer J Clin 2013;63:11-30.
3. August DA, Ottow RT, Sugarbaker PH. Clinical perspective of human colorectal cancer metastasis. Cancer Metastasis Rev1984;3:303-24.
4. Tonyali O, Sumbul AT, Ozturk MA, Koyuncuer A, Ekiz F. A case of rectal adenocarcinoma presented with palatine tonsil metastasis. J Oncol Pharmacy Pract 2014;22:341-3.
5. Van Cutsem E, Nordlinger B, Adam R, Kohne CH, Pozzo C, Poston G, et al. Towards a pan-European consensus on the treatment of patients with colorectal liver metastases. Eur J Cancer 2006;42:2212-21.
6. Hess KR, Varadhachary GR, Taylor SH, Wei W, Raber MN, Lenzi R, et al. Metastatic patterns in adenocarcinoma. Cancer 2006;106:1624-33.
7. Iiyama T, Watanabe H. Scrotal metastasis from ureteral cancer. J Urol 2001;165:1637.
8. Aydin GB, Ciftci AO, Yalcin B, Akcoren Z, Caglar M, Senocak ME, et al. Paratesticular metastasis from Wilms tumor associated with a hydrocele. Pediatr Blood Cancer 2006;47:97-9.
9. Nouhaud FX, Di Fiore F, Noel N, Gobet F, Pfister C. Scrotal metastasis from a nonmuscle-infiltrative bladder cancer: a surprising clinical evolution. Urology 2012;80:e37-8.
10. Norberg SM, Oros M, Manucha V, Eun D, Bilusic M. Loss of e-cadherin and retinoblastoma genes in a case of urothelial carcinoma with scrotal metastasis. Can J Urol 2015;22:7755-7.
11. Pichler R, Tulchiner G, Aigner F, Horninger W, Heidegger I. Paratesticular Metastasis of a Clear-Cell Renal-Cell Carcinoma With Renal Vein Thrombus Mimicking Primary Testicular Cancer. Clin Genit Cancer 2017;15:e123-e6.
12. Leung ST, Chu CY, Lai BM, Cheung FM, Khoo JL. Scrotal wall metastasis as the first manifestation of primary gastric adenocarcinoma. Hong Kong Med J 2014;20:70-3.
13. Thomas R, Swamy S. Rare case of gastrointestinal stromal tumor presenting with scrotal metastasis. Ind J Surg 2015;77:188-9.
14. Coussa-Koniski ML, Maalouf PA, Raad NE, Bejjani NA. Scrotal wall metastasis from a primary lung adenocarcinoma. Respir Med Case Rep 2015;15:77-9.
15. Gates O. Cutaneous Metastases of Malignant Disease. Am J Cancer 1937;30:718-30.
16. Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol 1993;29:228-36.
17. Gmitter TL, Dhawan SS, Phillips MG, Wiszniak J. Cutaneous metastases of colonic adenocarcinoma. Cutis 1990;46:66-8.
18. Reingold IM. Cutaneous metastases from internal carcinoma. Cancer 1966;19:162-8.
19. Shetty MR, Khan F. Carcinoma of the Rectum with Scrotal Metastases. Br J Urol 1988;62:612.
20. Boucher KW, Heymann WR. Ulcerated papules of the scrotum. Arch Dermatol 2001;137:495-500.
21. Hayashi H, Shimizu T, Shimizu H. Scrotal metastases originating from colorectal carcinoma. Clin Exp Dermatol 2003;28:226-7.
22. Reuter J, Bruckner-Tuderman L, Braun-Falco M. Epidermotropic scrotal metastasis of colorectal cancer. Int J Color Dis 2007;22:1133-4.
23. McWeeney DM, Martin ST, Ryan RS, Tobbia IN, Donnellan PP, Barry KM. Scrotal metastases from colorectal carcinoma: a case report. Case J 2009;2:111.
24. Balta I, Vahaboglu G, Karabulut AA, Yetisir F, Astarci M, Gungor E, et al. Cutaneous metastases of rectal mucinous adenocarcinoma mimicking granuloma inguinale. Int Med 2012;51:2479-81.
25. Ozgen A, Karakaya E, Bozdogan N. Scrotal skin metastasis from rectum adenocarcinoma. Rare Tumors 2013;5:e60.
26. Udkoff J, Cohen PR. Adenocarcinoma of the colon presenting with scrotal metastasis: case report and review of the literature. Dermatol Online J 2016;22:13030.
27. Dehal A, Patel S, Kim S, Shapera E, Hussain F. Cutaneous Metastasis of Rectal Cancer: A Case Report and Literature Review. Perm J 2016;20:74-8.
28. Lookingbill DP, Spangler N, Sexton FM. Skin involvement as the presenting sign of internal carcinoma. A retrospective study of 7316 cancer patients. J Am Acad Dermatol 1990;22:19-26.
29. Swofford BP, Dragovich T. Sigmoid Adenocarcinoma with Regional Scrotal Metastasis. Case Rep Oncol 2017;10:416-9.
30. Hanash KA, Carney JA, Kelalis PP. Metastatic tumors to testicles: routes of metastasis. J Urol 1969;102:465-8.
31. Pienkos EJ, Jablokow VR. Secondary testicular tumors. Cancer 1972;30:481-5.
32. Fowler A, Cook R, Biggs M, Little N, Assaad N, McDonald K. Survival of patients following neurosurgical treatment of colorectal adenocarcinoma metastasis in the Northern Sydney-Central Coast area. J Clin Neurosci 2008;15:998-1004.
33. WroĊski M, Arbit E. Resection of brain metastases from colorectal carcinoma in 73 patients. Cancer 1999;85:1677-85.
34. Michail P, Amith I, George S, George MK. A case of calcified metastatic colorectal adenocarcinoma mimicking a benign lesion: pitfalls in diagnosis. Case Rep Oncol Med 2015;2015:936260.
35. Melis M, Scintu F, Marongiu L, Mascia R, Frau G, Casula G. Inflammatory cutaneous metastasis from rectal adenocarcinoma: report of a case. Dis Colon Rectum 2002;45:562-3.
36. Goris Gbenou MC, Wahidy T, Llinares K, Cracco D, Perrot A, Riquet D. Atypical Phimosis Secondary to a Preputial Metastasis from Rectal Carcinoma. Case Rep Oncol 2011;4:542-6.
37. Wu G, Gu BJ, Nastiuk KL, Gu J, Wu DL. Metastasis to scrotal skin as the initial manifestation in a patient with rectal adenocarcinoma: a rare case report and literature review. Asian J Androl 2016;18:492-3.
| Files | ||
| Issue | Vol 57, No 4 (2019) | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/acta.v57i4.1847 | |
| Keywords | ||
| Colorectal cancer Scrotal lesion Skin involvement Metastasis | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Moghimi M, Aryanfar A, Vahedian-Ardakani H, Joukar F. Scrotal Lesions of Metastatic Rectal Adenocarcinoma: Case Report and Literature Review. Acta Med Iran. 2019;57(4):262-266.
